Oddities, musings and news from the health world

Is Facebook healthy for the doctor-patient relationship?

August 12, 2009 | 2:01
pm

If you’re on Facebook, you’ve likely faced this dilemma:
Someone you know through your work has asked to become your online friend. You
don’t want to be rude and say no, but you’re also a bit queasy about giving
professional acquaintances full access to your personal life online. What
should you do?

Dr. Sachin H. Jain encountered this problem in his second
week of internship, when a woman whose baby he helped deliver as a medical
student asked to become his Facebook friend. As he writes in this week’s New
England Journal of Medicine, he was wary of allowing his former patient to see
his list of friends, view his photos or read his personal blog. On the other
hand, he didn’t want to be a jerk.

“The anxiety I felt about crossing boundaries is an old
problem in clinical medicine, but it has taken a different shape as it has
migrated to this new medium,” he writes.

What could go wrong? Plenty, he speculates.

Patients could call a doctor’s medical judgment into
question after viewing Facebook photos of a festive holiday party that involved
a bit too much spiked eggnog. Or a physician who lists herself as “single” on
her Facebook profile could find herself being asked out by patients who
probably wouldn’t have inquired about
her relationship status in person. Or a nurse might blow off steam by blogging
about a difficult patient without remembering that she had friended one of the
patient’s relatives, who would have access to all the gory details. These are
some of the reasons medical schools now advise students to think twice
about what they post on social networking sites such as Facebook and
MySpace.

But without Facebook, a grassroots group called Doctors for
Obama might not have persuaded thousands of physicians to flood Barack Obama’s
campaign with their ideas about health policy during the 2008 presidential
election. “This group of physicians continues to have a voice in the Obama
administration, largely on the strength of its Facebook-created network of
members,” Jain writes.

So how did he handle his patient’s request? He accepted,
partly because he was curious to see how her baby was doing.

It turned out the patient did have an ulterior motive – she was
thinking about applying to med school herself. Jain said he was happy to
dispense advice, because that was in keeping with the doctor-patient
relationship. Among his suggestions: Be careful about how you manage your
online identity.